Medicare Advantage

Sioux Falls Medicare Advantage in 2027: the five carriers and the plan types they sell

Minnehaha County has 21 Medicare Advantage plans for 2027. Compared with 2026, 6 plans are not coming back, 5 are new, and 15 continuing plans changed in some way you should check before December 7, 5 of them under a new name. This guide covers what those numbers mean for Sioux Falls, not which plan to pick.

Medicare AdvantageSioux Falls, SD

Sioux Falls, S.D. — If you are shopping for a Medicare Advantage plan here for 2027, the first thing to know is who is selling and what kind of plan each one offers. Sioux Falls sits in Minnehaha County, where five carriers are on the shelf next year, and they lean on different plan structures — HMO, PPO and the less-common Cost plan — plus a handful of Special Needs Plans built for specific situations. Understanding those labels is the fastest way to narrow a field of 16 down to the ones that fit how you actually get care.

Who sells Medicare Advantage in Sioux Falls

Five carriers file plans in Minnehaha County for 2027. Compared with the 2026 lineup, 11 plans continue, 5 are new, 6 are not returning, and 5 have been renamed; 10 continuing plans change something in their terms, and those changes are spelled out in each plan's Annual Notice of Change. Wellmark Advantage Health Plan is not offering plans in the county next year. The full table below lists every plan by carrier and type.

A larger number of plans from one carrier is not a signal of quality — it usually means the insurer has built out several tiers or added Special Needs Plans for specific groups. What matters more is the plan type and whether your doctors, hospitals and pharmacies are in that plan's network.

How the plan types differ

Medicare Advantage comes in a few flavors, and the label on the plan tells you a lot about how it works.

HMO (Health Maintenance Organization). You pick a primary care doctor and generally stay inside the plan's network. Referrals are often required to see a specialist. Out-of-network care is usually not covered except in emergencies.

HMO-POS (Point of Service). A twist on the HMO that lets you go out of network for certain services, usually at a higher cost.

PPO (Preferred Provider Organization). More flexible than an HMO. You can see out-of-network providers who accept Medicare, though you'll typically pay more. Referrals usually aren't required. Twelve of the 22 plans in the county are PPOs, offered by Aetna, Align, UnitedHealthcare and Wellmark.

PFFS (Private Fee-for-Service). A plan that sets its own payment terms with providers; any doctor who accepts those terms can treat you.

Cost plans. A less-common option, and something of a Minnesota-and-neighbors specialty. With a Cost plan, in-network care works like Advantage, but if you go out of network you can use Original Medicare for that service instead. All eight Cost plans in the county come from Medica.

Special Needs Plans, explained

Special Needs Plans (SNPs) are Medicare Advantage plans limited to people who meet certain criteria. Six of the 22 plans in Minnehaha County are SNPs. There are three kinds:

• D-SNP (Dual Eligible) for people who have both Medicare and Medicaid. The Aetna Medicare Dual, Aetna Medicare Full Dual, UHC Dual Complete SD-Q1 and UHC Dual Complete SD-S2 plans fall in this category.
• C-SNP (Chronic Condition) for people with qualifying long-term conditions such as diabetes or heart failure.
• I-SNP (Institutional) for people who live in a nursing facility or need that level of care at home. The two Great Plains Medicare Advantage plans are I-SNPs.

If you don't qualify for the group a SNP is designed for, you can't enroll in it — even if it looks appealing on paper.

What every plan here has in common

All 16 Medicare Advantage plans in the county for 2027 include Part D prescription drug coverage. If you want drug coverage bundled with your medical plan, an MA-PD is the practical route.

A few program-level Part D numbers to keep in mind: the maximum Part D deductible is $615 for 2026 and $700 for 2027, and the annual out-of-pocket cap for covered drugs is $2,100 for 2026 and $2,400 for 2027. The old coverage gap ("donut hole") went away in 2025, so Part D now has three phases instead of four. If your drug costs are lumpy, ask about the Medicare Prescription Payment Plan, which lets you spread out-of-pocket drug costs across monthly bills.

How to actually narrow the list

Rather than starting from "which plan is best," start from what's fixed in your life:

1. Your providers. Check that the doctors, clinics and hospitals you use are in-network for any plan you're considering. Networks vary carrier by carrier, even in the same city. 2. Your prescriptions. Enter each drug on Medicare's Plan Finder to see how it's covered under each plan's formulary. 3. How you travel. If you spend part of the year outside South Dakota, a PPO or Cost plan may give you more flexibility than an HMO. 4. Whether a SNP fits. If you have Medicaid too, or you're in an institutional setting, a D-SNP or I-SNP may offer benefits tailored to that situation.

Star Ratings are another data point on Medicare.gov; they're meant to give you a sense of a plan's quality and service history. Use them alongside network and drug checks, not instead of them.

Key dates for 2027 coverage

The Annual Enrollment Period runs Oct. 15 through Dec. 7, and choices made in that window take effect Jan. 1. If you're already in a Medicare Advantage plan and want to switch (or drop back to Original Medicare), the Medicare Advantage Open Enrollment Period gives you a second chance from Jan. 1 through March 31.